Comparing Transvaginal Ultrasonography Results with Dilatation and Cureage Findings inEvaluation of Endometrial Cancer in Women withPostmenopausal Bleeding

Background/Objective: Postmenopausal vaginal"nbleeding is a common and important clinical problem."nPMB is caused by endometrial cancer in about 10%"nof patients. Most reports indicate that endometrial"natrophy is the most common cause of PMB. Most of"nthem for more evaluation are admitted for D&C. The"npurpose of this study was to find in which patients,"nTVS can replace D&C?"nPatients and Methods: From April, 2008, through"nJune, 2009, 98 women with PMB underwent TVS"nand histopathologic evaluation of the endometrium"nafter D&C or after hysterectomy. Normal appearance"nat transvaginal sonography was defined as a thin (≤"n5mm) and diffuse smooth with smoothly marginated"nand homogeneously echogenic endometrium. But a"nsuspicious appearance was defined as either irregular"nthickening of the endometrium or an inhomogeneous"nendoluminal mass or pedunculated endoluminal mass"nor any endometrial thickness above 5 mm."nResults: At histologic examination:of 98 women, 44"n(45%) had an atrophic endometrium, 11 (11%) had"ncarcinoma, 10 (10%) had hyperplasia, 28 (29%) had"npolyps and five (5%) were others (ovarian tumor,"nleiomyosarcoma and multiple or giant leiomyoma)."nFor carcinoma, the sensitivity of TVS was 100%, the"nspecificity was 41.38%, PPV was 17.4% and NPV was"n100%. In addition, the specificity of TVS for atrophic"nendometrium was 100%."nConclusion: TVS in patients with PMB is an"nexcellent tool for the determination of whether"nfurther investigation with curettage or some form"nof endometrial biopsy is necessary and it sensibly"ndecreases the number of invasive methods. TVS also"nimproves clinical decision making and the clinician's"ndiagnostic certainty.